音乐疗法对肝癌TACE后急性腹痛的影响效果观察

目的观察在肝癌TACE(肝动脉介入化疗栓塞术)后急性腹痛中应用音乐疗法的效果。方法将选取的80肝动脉介入化疗栓塞术患者随机分为对照组和观察组,对照组患者对常规的护理方法进行使用,观察组患者在常规护理方法的基础上对音乐放松疗法进行使用。结果对照组患者的SAS评分要远远高于观察组患者的,两组间比较具有统计学意义(P0.05);对照组患者的VAS评分远远高于观察组患者的,两组间比较具有统计学意义(P0.05)。结论综上所述,在肝癌TACE患者术后的康复中应用音乐疗法,可以将患者的焦虑水平和疼痛程度大大降低,对患者具有较好的护理效果,所以在实际的临床工作中要将其推广力度不断加大。     

血府逐瘀汤治疗原发性肝癌TACE术后气滞血瘀型疼痛30例

目的 观察血府逐瘀汤治疗原发性肝癌经导管动脉化疗栓塞（transcatheter arteriachemoembolization, TACE）术后气滞血瘀型疼痛的临床疗效。 方法 将60例原发性肝癌TACE术后气滞血瘀型疼痛患者随机分为治疗组和对照组,每组30例。治疗组给予血府逐瘀汤口服,对照组予以中药汤剂安慰剂口服。治疗前后比较两组患者疼痛数字分级评分（numerical rating scale, NRS）及Karnofsky功能状态评分（karnofsky performance status, KPS）的变化。 结果 治疗后两组NRS评分均显著下降,治疗组治疗前后NRS评分差值显著大于对照组（P＜0.05）。治疗后对照组KPS评分显著降低,而治疗组显著升高,两组治疗前后差值比较,差异具有统计学意义（P＜0.05）。治疗组NRS及KPS评分改善情况均显著优于对照组（P＜0.05）。 结论 血府逐瘀汤能有效减轻原发性肝癌TACE术后气滞血瘀型疼痛,提高患者生活质量。     

耳穴压豆在肝癌肝动脉化疗栓塞术后便秘患者中的应用

目的 探讨耳穴压豆在肝癌肝动脉化疗栓塞术后便秘患者中的应用。方法 选取2018 年6 月～2019 年5 月我科拟行经肝动脉化疗栓塞的原发性肝癌患者,随机分为试验组和对照组,每组各40 例;两组患者均给予常规治疗护理方案,试验组在对照组基础上于患者行动脉化疗栓塞术后当日给予耳穴压豆,观察两组患者术后肛门首次排便时间及第0、2、4、6 天患者便秘症状评分。结果 试验组及对照组肝动脉化疗栓塞术后肛门首次排便时间分别为（29.83±4.01）h、（48.23±7.11）h（t=-8.151,P=0.000）,两组差异有统计学意义（P＜0.05）,试验组便秘症状评分显著优于对照组（P＜0.05）。结论 耳穴压豆可以有效预防肝动脉化疗栓塞术后便秘的发生,值得临床推广。     

优质护理服务对肝动脉化疗灌注栓塞术后疼痛的影响

目的探讨优质护理服务对肝动脉化疗灌注栓塞术后疼痛的影响.方法 将90例肝动脉化疗灌注栓塞术后的肝癌患者随机分成2组,观察组45例在给予常规护理的基础上,给予心理护理、环境的干预及合理的止痛等优质护理服务,对照组给予常规护理.结果 观察组的疼痛程度评分低于对照组(P<0.05).结论 优质护理服务能有效减轻肝动脉化疗灌注栓塞术后患者的疼痛程度.     

综合护理干预对TACE术后疼痛的影响观察

目的 探讨综合护理干预对肝动脉灌注化疗栓(TACE)术后疼痛的影响.方法 将60例接受TACE治疗的肝癌患者随机分成2组,对照组给予常规护理,干预组在常规护理的基础上给予综合护理,比较2组患者术后疼痛情况及睡眠情况.结果 干预组患者术后的疼痛评分明显低于对照组,干预组患者术后的睡眠质量明显高于对照组,差异均有统计学意义(P＜0.05).结论 综合护理干预能降低TACE术后疼痛,提高患者的睡眠质量.     

原发性肝癌患者肝动脉化疗栓塞术后肝区疼痛护理效果观察

目的探讨原发性肝癌患者肝动脉化疗栓塞术后肝区疼痛护理效果。方法选择该院2009年4月—2011年4月间收治的原发性肝癌行肝动脉化疗栓塞术的患者60例,随机分为两组,对照组30例行常规护理,观察组30例针对疼痛进行观察并行针对性干预,就两组临床资料进行回顾性分析。结果观察组Ⅰ、Ⅱ级疼痛率显著高于对照组,Ⅲ、Ⅳ度疼痛率显著低于对照组,差异有统计学意义（P〈0.05）。观察组护理满意度为96.7%,对照组为80%,差异有统计学意义（P〈0.05）。结论原发性肝癌患者肝动脉化疗栓塞术后肝区疼痛实施针对性护理干预,可显著降低疼痛程度,确保手术顺利进行。     

评价舒适护理在肝动脉导管栓塞化疗术中的价值

目的 探讨舒适护理在肝动脉导管栓塞术（TACE）治疗肝癌患者中的应用价值.方法 选取159例TACE术后患者分为对照组74例和观察组85例,对照组实施常规护理,观察组实施系统舒适护理.比较两组患者舒适度、满意度及术后不适反应的发生情况.结果 观察组患者的舒适度、满意度明显好于对照组（P 〈 0.05）,同时观察组术后不适反应的发生率较对照组显著降低（P 〈 0.05）.结论 开展舒适护理可有效减少TACE患者术后不适反应的发生,提高患者对护理工作的满意度及舒适度.     

苦参素对原发性肝癌肝动脉栓塞及栓塞化疗术后综合征的疗效观察

目的探讨苦参素对原发性肝癌经导管及微导管肝动脉栓塞及动脉栓塞化疗（transcatheter arteral chemoembolization,TACE）后综合征的改善。方法回顾性分析选择纳入标准的原发性肝癌60例,定量资料,分为治疗组（TACE＋苦参素）30例,对照组30例,TACE术前一周、术后一周及一月检测肝功能,观察患者肝动脉栓塞化疗术后综合征及肝功能的情况。结果TACE术后治疗组、对照组的肝功能均升高,经过护肝治疗后均稍高于治疗前的水平,谷草转氨酶（AST）及总胆红素（TBIL）两组差异有统计学意义（P〈0．05）;两组的谷丙转氨酶（ALT）差异无统计学意义（p〉0．05）;治疗组较对照组病人术后栓塞综合征缓解较快,两组差异有统计学意义（P〈0.05）。术后一周、术后定期复查肝功能,栓塞化疗术后综合征症状均恢复和缓解。结论苦参素可缓解原发性肝癌TACE栓塞术后综合征症状。     

强化护理对中晚期肝癌患者TACE术后疼痛程度和生活质量的影响

目的探讨强化护理对中晚期肝癌患者肝动脉化疗栓塞术(TACE)术后疼痛程度和生活质量的影响。方法选取2016年11月至2018年10月郑州大学第一附属医院收治的76例经TACE治疗的中晚期肝癌患者,根据入院时间分为对照组和观察者,每组38例。对照组患者接受常规护理,观察组在常规护理的基础上接受强化护理。比较两组患者护理前后视觉模拟痛觉量表(VAS)评分。借助肝癌患者生活质量测定量表(QOL-LC)评估患者护理前后生活质量,包括躯体功能、社会功能、心理功能。结果护理后,两组患者VAS评分低于护理前,观察组患者VAS评分低于对照组,差异有统计学意义(均P<0.05)。护理后,两组患者躯体功能评分、社会功能评分、心理功能评分均高于护理前,观察组患者躯体功能评分、社会功能评分、心理功能评分均高于对照组,差异有统计学意义(均P<0.05)。结论强化护理有助于改善行TACE的中晚期肝癌患者的疼痛状况,提高生活质量。     

护理干预在原发性肝癌首次肝动脉化疗栓塞治疗患者中的应用

目的探讨护理干预在原发性肝癌首次肝动脉化疗栓塞治疗患者中的应用效果。方法以126例原发性肝癌首次肝动脉化疗栓塞治疗患者为研究对象,随机分为观察组和对照组,观察组采取常规护理+护理干预措施,对照组采取常规护理措施,比较两组患者术后并发症发生率、疼痛程度、可正常饮食的时间及患者满意度。结果观察组术后并发症发生率、疼痛程度、可正常饮食时间显著低于对照组,护理满意度显著高于对照组。结论在临床上对原发性肝癌首次肝动脉化疗栓塞治疗患者实施护理干预可以降低术后并发症发生率、减轻术后疼痛程度、减轻胃肠道反应及提高患者满意度,适合在临床推广应用。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.